Provider Demographics
NPI:1043977036
Name:MCLAUGHLIN, ANGELETTA ELAINE
Entity Type:Individual
Prefix:
First Name:ANGELETTA
Middle Name:ELAINE
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8246 LORAIN ST SE
Mailing Address - Street 2:
Mailing Address - City:MASURY
Mailing Address - State:OH
Mailing Address - Zip Code:44438-1617
Mailing Address - Country:US
Mailing Address - Phone:133-097-9728
Mailing Address - Fax:
Practice Address - Street 1:311 NILES CORTLAND RD NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1977
Practice Address - Country:US
Practice Address - Phone:234-806-4102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator